Ryan's Story

 By Helen L. Kaye, M.Ed., CCC/SLP

We were contacted by Ryan's mother because of her concerns about his poor school grades and stuttering. She explained that he was the oldest of her five children and had always done well in school. They had recently re-located here from a small town in New Jersey and Ryan had been the most upset of all her children about the move.

Ryan had celebrated his 13`h birthday just days before they left a home town where Ryan had many friends. The last few weeks before the move Ryan's behavior had escalated at home and he had been sullen and defiant with his parents and siblings. His speech had also deteriorated and he had lapsed back into the stuttering that he had had many years ago when he had first started kindergarten. The stuttering at that time seemed to coincide with the first few months of school, but it had subsided on its own as Ryan made new friends and got accustomed to the school routine.

Ryan's mother explained that her husband also stuttered, but only at home. Apparently he had successfully hid his speech problem from co-workers and his supervisors by avoiding certain words and speaking very quickly. This move to North Carolina was the result of a promotion in the high tech firm in which he had worked since he left technical school fifteen years ago. They had both looked forward to the increase in pay and the warmer climate that this move afforded, but now Ryan had them upset and unsure that they had made the right decision.

The mother described Ryan as a bright and sensitive child who was well-liked by peers and had many friends up north. He seemed to always do well in school and was frequently on the honor roll.

Ryan presented as a small, skinny 7th grader. He hung his head and answered most questions with a grunt or a shrug of his thin shoulders. He clearly did not want to be in our office and refused to engage in conversation. So we got down to business and administered a stuttering assessment for youth. He did well on rote memory items like reciting the alphabet, naming the days of the week, and labeling pictures of common objects. But when he had to use a sentence or read aloud a paragraph, his speech broke down into frequent sound and syllable repetitions, silent tension-filled blocks, and numerous starts and revisions. It was also noted that he blinked his eyes a lot and grimaced when the words would not come out.

Ryan admitted that he avoided speaking in class because of fear of teasing. If the teacher called on him, he would mumble "I dunno" and she would go on to another student. No one at his school knew about the stuttering. He had kept to himself the past four weeks and now the other kids seemed to ignore him.

Ryan was unsure about what we could do to help him. He did admit that he was unhappy and that he would like to have friends to hang around with like he did back home. He also grudgingly admitted that he didn't like having the teacher and his classmates think that he was "dumb" and never knew the answers. So we made an agreement that we would work on fixing his stuttering so he would not be embarrassed to talk to new kids. We also talked about extra-curricular activities that he enjoyed. He said that he had played soccer and had been on the track team in his old school. I encouraged him to sign up for these sports here and mom enrolled him before the next session.

In therapy we worked on gentle onset of phonation so that he did not tense up his throat whenever he perceived that he was going to stutter. We practiced using this technique in rote counting, reciting the alphabet, and naming common objects, things that he
perceived as easy to say. We gradually worked on short sentences like "I see the (picture)" and "That's a ". When this became easy, we worked on reading aloud sentences from a third grade reader. Gradually we worked up to reading aloud from his
school textbooks and discussing what he had read. Throughout each session we always concentrated on using a small puff of air to blow open his vocal cords at the start of each utterance. We also did some visual imagery of his mouth and vocal cords being relaxed.

About a month after we had begun therapy Ryan came in wearing his track suit and said that his mom was picking him up early to go to a meet that afternoon. And by the way, he had made a few new friends that also ran track and his mom was picking them up too, so they could ride to the meet together. When asked how his speech was with his new friends, he just shrugged and said he didn't have any trouble talking to them.

Ryan was seen on a weekly basis through the fall and his speech continued to improve. Around Christmas he came in and proudly showed us his report card; he had made the honor roll. We continued to see Ryan twice a month through the winter and gradually tapered off sessions in the spring. At this point Ryan had made many friends, was active in school athletics, and was looking forward to the summer. On our last session before school ended he came in with a big grin and announced that his dad had purchased a ski boat and he was looking forward to learning to water ski over the summer. He admitted that the move to North Carolina wasn't so bad after all!

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